Individual
SHANNON BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1325 SW ORALABOR RD STE 220, ANKENY, IA 50023-8046
(515) 720-4377
Mailing address
8875 SILVER ST, WEST DES MOINES, IA 50266-8542
(515) 321-8245
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A-114718
IA
363L00000X
Nurse Practitioner
A114718
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992047401
—
IA
Enumeration date
03/22/2013
Last updated
03/12/2023
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